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腹腔镜胰腺二管切除术后30天内无计划的重新手术的原因和预测因素:全面分析

Shiwei Zhang¹, Dipesh Kumar Yadav², Gaoqing Wang¹

¹Department of Hepatobiliary and Pancreatic Surgery, Ningbo Medical Center Lihuili Hospital, Ningbo University, Ningbo, Zhejiang, China.

Frontiers in oncology

|September 11, 2024

概括

在腹腔镜胰腺双管切除术 (LPD) 后,有7.4%的患者发生了未计划的重新手术,主要是由于出血. 关键的危险因素包括低的前白蛋白,高的CRP,血管重建,软的胰腺质地和小的胰腺管径.

科学领域:

胃肠病学和肝病学
手术瘤学手术瘤学
最少侵入性的手术

背景情况:

laparoscopic 胰腺二管切除术 (LPD) 是一种复杂的手术,有可能导致显著的发病率.
在LPD后30天内重新进行非计划性手术代表了手术质量和患者结果的关键指标.
识别特定的风险因素对于提高患者安全和降低医疗保健成本至关重要.

研究的目的:

为了确定和分析风险因素和原因,在腹腔镜胰腺二切除术 (LPD) 后的30天内,无计划的重复手术.
提供数据,可以为减少重新运行率的策略提供信息.
为改善LPD患者的外科手术期间的治疗方案.

主要方法:

在2017年至2024年期间接受LPD的311名患者的回顾性分析.
统计分析包括单变量和多变量方法来确定显著的风险因素 (P < 0.05).
详细审查人口统计,临床和操作参数.

主要成果:

23名患者 (7.4%) 需要进行意外的重复手术,主要是因为术后出血 (82.6%).
通过多变量分析确定的独立风险因素包括低的术前血清前白蛋白,在术后第7天升高的C反应蛋白 (CRP),血管重建,软胰腺纹理和主胰腺管径≤3毫米.
再次手术的其他原因包括静脉泄漏,腹部感染和 afferent循环阻塞.

结论:

手术后出血是LPD后早期计划外的重新手术的主要原因.
特定的手术前和手术期间的因素显著增加了重新手术的风险.
针对这些已识别的风险因素的针对性术后管理对于改善结局和降低LPD患者的重新手术率至关重要.

关键词:

laparoscopic 腹腔镜胰腺双切除术胰腺瘤是一种瘤.术后出血术后出血有关风险因素的风险因素.不规划的重新启动.

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